# RIVERVIEW HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Countryside Manor Health & Living
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366587966
- **Authorized official:** MR. KENT RODGERS (CFO)
- **Authorized official phone:** (812) 332-2265

## Contact information

- **Practice address:** 205 MARINE DR, ANDERSON, IN 46016-5937
- **Practice address phone:** (765) 649-0455
- **Practice address fax:** (812) 334-0853
- **Mailing address:** 2749 E COVENANTER DR, BLOOMINGTON, IN 47401-5454
- **Mailing address phone:** (812) 332-2265
- **Mailing address fax:** (812) 334-0853

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060001601 | IN | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 05/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100267190A | — | IN |